Understanding Thyroid Markers and Panels

 Hormones of all types are released by their respective gland in response to a communication from another gland or chemical such as immune inflammatory chemicals.  The hormones are found in “protein bound” or inactive hormone, and “unbound” or free hormones which actively interact with hormone receptor sites on a variety of cells and ultimately “do their job.”  There is typically some type of chemical transition to the active form, and another chemical interaction with the target cells, tissues and organs. 

 TSH:  Thyroid Stimulating Hormone is released by the pituitary gland in response to a release of Thyrotropin-Releasing Hormone (TRH) in the hypothalamus.  This is the most common marker used to assess thyroid function.  The TSH levels increase when T4 levels drop, and decreases when T4 increases.  This is often the only test performed in the traditional medical model as a screen for thyroid disorders, or more accurately, as a screen for a “need” for thyroid hormone replacement.  TSH testing does not accurately report autoimmune issues, conversion of T4 to T3, or the communication networks between the thyroid and pituitary.  If it is high or low, it does indicate hyper or hypo thyroid function, respectively.

 Total T4:  T4 is the actual hormone released by the thyroid gland, called Thyroxine.  This test measures what is called “bound” and “unbound” or free Thyroxine.  Thyroxine is bound by proteins and technically inactive until it is released chemically to free T4.  This test best reflects total output of the thyroid gland, but there are other factors that can inhibit the unbinding or freeing of the hormone leading to low “active” thyroxine. 

 T3 Uptake:  This measures the number of sites for active T3 to bind with T4 binding proteins, so really is a protein measurement that interacts with T3.  These protein binders are affected directly by changes in steroid hormones, particularly testosterone and estrogen. 

 Free Thyroxine Index:  FTI is a calculation using Total T4 and T3 Uptake, and helps to determine the amount of active T4 available. 

 Free T4:  This is a direct measure of the active T4 in the blood, but still must be converted to T3 to impact your metabolism and energy, so more accurately, it is the measure of the potential thyroid output if the next step is working. 

 Free T3:  This test measures the free or active T3 hormone levels, which is the actual hormone that binds to thyroid receptors and culminates in an increase in metabolism and energy.  So you still need healthy receptors for this hormone to be effective. 

 Reverse T3:  This is a measure of a bound T3, that is unable to be used for your metabolism, and is increased by elevated cortisol levels, which is a “stress” induced hormone. 

 Thyroid Antibodies:  These are immune markers that indicate that the immune system has “tagged” thyroid tissues for destruction.  It is an indicator of some level of immune dysregulation, and does not reflect a thyroid dysfunction, although thyroid hormones are affected in the attack.  This test is partnered with the Lymphocyte subpopulation study, which informs whether the immune system is out of regulation, or unbalanced, and in which direction it is shifted.  Many people with thyroid symptoms, but “normal” thyroid tests, namely TSH, have an autoimmune process in play affecting the function and feel of the thyroid hormones. 

 Adrenal Stress Index:  This is a test that measures cortisol and DHEA, both adrenal hormones, using saliva samples throughout the day so we actually get a picture of the rhythm of the adrenal output.  Chronic elevated cortisol or low cortisol will directly impact the thyroid output and conversion to active hormone. 

 As mentioned, all hormones affect all hormones, so with more resistant or difficult situations, it is often necessary to check other hormones to understand the impact of the messages coming from other tissues.  The immune system and adrenal system has the most direct impact and will confuse the picture in treating thyroid, which is why we suggest testing these at the outset to get the whole picture. 

 And, if you think about it…when you get stressed you get sick, and when you get sick you get tired.  So if these systems are dysfunctional, you will always feel just a little (or a lot) sick and tired. 

 If you are “DONE” feeling sick and tired, we have your solution.  You will be amazed at the level of insight we can get from this testing, I guarantee it.  And, more importantly, this information will provide the “map” that leads you from low thyroid and metabolism, and feeling lousy, to your old self again.

The Influences of Thyroid Hormones on Physiological and Metabolic Function

 Bone:  Deficiency of thyroid hormones lead to a decrease in bone development and an abnormal architecture of the bone that is created.  Generally, a functionally low (which means low but not flagged as of yet) serum calcium is noted in hypothyroidism.  Elevated thyroid hormones causes an increased serum calcium, as it pulls calcium from the bone, leading to increased risk of pathological fractures of the spine and weight bearing joints.

 GastroIntestinal Function:  Transit time is affected directly by thyroid hormones as is absorption of nutrients. 

 Male Hormones:  Hypothyroidism has been linked to diminished libido and impotence.  Although this condition is more rare in men, it must be considered in treating these conditions.

 Liver and Gallbladder Function:  Low thyroid function caused decreased liver clearance and gall bladder congestion through thickening of the bile, often also associated with an elevation of cholesterol.  Unfortunately, also often treated with cholesterol lowering drugs while the thyroid function is the cause of the elevated cholesterol. 

 Body Composition:  As you may know all too well, low thyroid function causes an inability to lose weight.  This is caused by a slowed conversion of glucose and fat into energy, and altering the way Human Growth Hormone (HGH) is metabolized in the body. 

 Blood Sugar Regulation:  Low thyroid slows the insulin response to glucose following eating carbohydrates or sugar and it also slows glucose uptake into cells and tissues, and slows absorption of glucose from the intestinal tract.  In other words, your entire energy production system is slowed.  It is quite confounding to your body and brain, in that the glucose is in the blood, but the tissues are not able to absorb it.  This really confuses the pituitary gland and adrenal glands, resulting in a “stress physiology,” even if life is good. 

 Cholesterol:  As mentioned earlier, low thyroid increases your cholesterol and triglycerides, so your doctor tells you your diet is poor.  You become even more strict in your diet, and the tissue starvation (low glucose, low energy) gets worse, which makes the stress physiology worse, which makes your cholesterol higher, which prompts your doctor to put you on cholesterol medication, which interferes with energy production, which further stresses your physiology…whew!  You are frustrated!

 Depression:  Low thyroid impairs the production of stimulating neurotransmitters, which are the chemicals that antidepressants work on.  Low stimulating neurotransmitters leaves you feeling depressed.

 Female Hormones:  Low thyroid changes the way estrogen is metabolized in the body, shifting toward a estrogen metabolite that has been proven to increase the risk of breast cancer. 

 Stress:  Low thyroid slows the elimination of the stress hormone cortisol, which leaves you feeling stressed out, not because of “stress,” but because the stress hormone can’t be removed efficiently. 

 Detoxification:  Low thyroid slows an enzyme critical for metabolic biotransformation, or detoxification, the process by which the body binds and removes all environmental chemicals, and normal byproducts of metabolism, including hormones.  “Toxicity” further slows your metabolism, and leads to headaches and other toxic symptoms.

 Digestion:  Low thyroid reduces the release of gastrin, which determines the output of hydrochloric acid in the stomach, leading to poor protein digestion, sour stomach, and GERD.

 Thermoregulation:  Regulation of body temperature is affected by low thyroid, resulting in hot flashes and night sweats, which is especially prominent in perimenopausal women.  This is often blamed on estrogen dropping, but may be directly caused by low thyroid. 

 PMS and Infertility:  Low thyroid affects the progesterone receptors, making them less sensitive to progesterone, which feels like low progesterone, although the progesterone levels may be normal.  Since the activity of progesterone is diminished, the health of the uterus is insufficient for implantation in the second half of the female cycle, leading to difficulties getting pregnant and PMS.  Low thyroid also reduces sex hormone binding proteins, leading to an increase in estrogen activity. 

 Anemia:  Low thyroid, as mentioned affects protein metabolism, which then lowers the red blood cell mass, which carries oxygen to tissues for metabolism of energy.  Yes, another mechanism for feeling lousy. 

 Homocysteine:  Low thyroid slows a process called methylation, often evidenced by elevated serum levels of homocysteine.  Elevated homocysteine in the blood has been proven as a risk factor for cardiovascular disease, alzheimers and other neurodegenerative disorders, and cervical dysplasia. 

 As you can see, living with low thyroid has far reaching effects on your health and function.  There are as many as 23 published mechanisms for thyroid function to be impaired.

Am I a candidate for Dr. Diehl’s treatments?
Not all patients will be accepted into our program. Dr. Diehl will make a determination of treatment acceptance after an initial case review, consultation and evaluation.
 
Are your treatments safe?
Yes, extremely safe and painless.

I go to a chiropractor now, what is the difference?
Dr. Diehl practices based on specific neurological protocols determined through a very thorough functional assessment.  We also use some of the most cutting edge technology in our office.  The highest quality nutrtional supplements and dietary modifications are recommended based on  lab results.

Do I need to stop taking my medications?
Please be advised that Dr. Diehl will never tell you to stop taking your medications.  That’s called practicing medicine without a license.  As your symptoms improve during the course of care, Dr. Diehl may recommend that you return to your physician to adjust your medication levels.

 Will my insurance cover the treatments?
Every insurance policy is different and the staff at Dr. Diehl’s office will check on your insurance coverage.  We will advise you of any coverage or limitations of coverage before any care is initiated.

How much do your treatments cost?
It varies due to individual patient findings.  After a thorough review of your case, Dr. Diehl will determine the course of care for your specific case.

WHAT MAKES US DIFFERENT……

 We treat patients structurally, neurologically and metabolically! 

 NO STONE IS LEFT UNTURNED TO DETERMINE THE EXACT CAUSE OF YOUR HEALTH CONDITION!

We use specific metabolic and neurological protocols

#1: SPECIFIC METABOLIC TESTING AND TREATMENTS:

I: Sensitivity Testing: to determine if you have a sensitivity to gluten (wheat, rye, oats, and barley), milk, eggs, yeast, and soy.  If you are sensitive to ANY of these food groups, it could be making you’re your thyroid condition worse as it will increase inflammation in your brain and throughout your body!

IF you suffer from Hashimoto’s thyroiditis, you need to be off of all gluten….NOW! 

 Here are some of the symptoms of these sensitivities:

Chronic pain or fatigue

Frequent indigestion

Bloated after eating

Frequent loose bowel movements

Constipation

Mouth ulcers or sores

Vomit often

 The only way to find out of you are suffering from any of these sensitivities is the run the test. 

 II. Complete Blood Panels

 By using specific blood tests such as:

 #1: A complete metabolic panel (CMP)

#2: A lipid panel

#3: A CBC (complete blood chemistry with auto differential)

 We can assess your adrenal glands, liver, kidneys, red/white blood cells and gut function with the above lab tests.  All can be affected with chronic health conditions.  By addressing any problems with your adrenal glands, blood chemistry, or gut function, we can help you to heal faster.  The CMP also allows us to check your blood glucose levels since glucose and oxygen are needed by the brain to function properly. 

What other tests of the thyroid are necessary?

•  Thyroid Stimulating Hormone (TSH): the message sent from a gland in the brain (pituitary) to the thyroid.
•  Free T3: an important hormone produced by the thyroid gland, considered to be the more biologically active hormone of the thyroid.
• Free T4: another important hormone produced by the thyroid gland.
•  Thyroid Binding Globulin (TBG): This test measures the amount of proteins in the blood that transport thyroid hormones to the cells.  Elevated testosterone can lower TBG levels and elevated estrogen can raise TBG levels.  Both can produce hypothyroid symptoms.
•  Thyroid Antibodies (TGB & TPO): checked in suspected cases of autoimmune thyroid disorders (see below)
• Total T4: this is a reflection of how much total T4 hormone there is in the blood
•  Free Thyroxine Index (FTI): this is an estimate of how much thyroxine is in the blood
• Resin T3 Uptake: this test measures the unsaturated binding sites on the thyroid proteins

 III: Adrenal Stress Index (ASI) :

You can test the adrenal glands with a test called an Adrenal Stress Index.  This is a salivary test much like DNA testing.  The adrenal glands sit right above the kidneys and they are your “stress” organs meaning that they react to stress.  If the patient has been or are currently under stress, this test is a must!

IF THE PATIENT SUFFERS FROM INSOMNIA AND/OR DIABETES, THIS TEST IS A MUST!  IT WILL MEASURE THEIR CORTISOL LEVELS. 

 IV. Immune Panels—EXTREMELY IMPORTANT!:

You could be suffering from an auto immune condition.  An autoimmune thyroid is called Hashimoto’s Thyroiditis. Your immune system could be attacking your thyroid.  This is why the immune panels are so important and NOT just the TPO and TGB thyroid antibodies.

 There are two parts to the immune system, TH1 and TH2.

 IL- 2 and TNF-alpha = TH1

TH1 is T-cells.  T-cells are the army that attacks and cleans up afterword. (Helper T-cells, Suppressor T-cells, NKC, regulatory T-cells, and macrophages. 

IL-4 and IL-10 = TH2

TH2 is B-cells.  B-cells make anti-bodies.  They tell T-cells what to kill.  If the testing comes back with a high B-cell count, the patient is TH2 dominant.

 T and B Lymphocyte & Natural Killer Cell Panel

 IL-2 ,TNF-alpha, IL-4, IL-10

 Natural Killer Cell Activity

You will want to determine if there is an active antigen or dysregulation.

 Active antigens are parasites, bacteria, virus, mold, yeast, fungi, protozoan, foods, chemicals, and heavy metals.

 The best indicator for an active antigen as the cause of the patient’s abnormal dominance is the “Helper/Suppresor” ratio on the T & B cell panel. (also called “CD4:CD8” ratio).

 The closer to 2.5 the ratio is (or if above that), the more likely it is that you’re dealing with an antigen.

 If the ratio is below 1.2, then you are most likely dealing with a dysregulation problem. 

V. Intestinal Permeability:  This test is used to determine if the patient suffers from leaky gut syndrome (LGS).

LGS or Leaky gut syndrome describes a condition of altered or damaged bowel lining, caused by antibiotics, toxins, poor diet, parasites or infection can lead to increased permeability of the gut wall to toxins, microbes, undigested food, waste or larger than normal macromolecules. It has been proposed that these substances affect the body directly, while others postulate an immune reaction to these substances.

 VI. HORMONE PANELS:  We can check hormone panels to determine if the patient suffers from low testosterone in males or low estrogen/progesterone levels in females. Symptoms related to decreased hormone levels may include depression, fatigue, mental fogginess, mood swings, hot flashes, sweating attacks, weight gain, and decreased physical stamina.

 INFLAMMATION: Finally, we may need to test for inflammation in your system by testing homocysteine levels and C-Reactive Protein (C-RP).  Many patients suffering from chronic health conditions suffer from inflammatory processes.  Just about every fibromyalgia patient that I have treated suffers from some form of chronic inflammatory process.

 GLUTATHIONE: We use Glutathione in our treatment of ALL chronic conditions.  Glutathione is the “mother-load” of anti-oxidants. Glutathione cannot be taken orally in pill form as the body will not absorb it.  We have seen miraculous changes in our patient population as a result of our specific glutathione protocols.  Glutathione is especially helpful with autoimmune diseases.

#2 Neurological Treatments Based on Specific Neurological Testing:

 #1: Oxygen therapy: Oxygen is fuel for your brain and nervous system.  Your brain and nervous system need two things to survive…..fuel and activation.  Fuel comes in the form of OXYGEN AND GLUCOSE.  By using oxygen, we will help you heal faster.  By using exercise with oxygen therapy (EWOT), we can increase firing to brain.  By increasing firing of brain, we help MANY chronic conditions. 

 #2: Brain-Based Therapy (BBT):  We use specific brain-based therapies such as:

 Active Therapeutic Movement – ATM2: Provides relief from chronic pain using active therapeutic movements to retrain the brain and nervous system to learn new pain free movement patterns.  This works great for improving posture, mobility and range of motion.  Many professional athletes, especially golfers, use the ATM2 as part of their rehabilitation and training programs.  It can be used with the knee, hip, shoulder, neck and back.  

• Whole Body Vibration:
• Provides benefits of both anaerobic and aerobic exercise
• Increases physical strength, dexterity, and endurance
• Increases balance and coordination
• Increases flexibility, range of motion and mobility
• Reduces arthritic pain, joint and ligament stress
• Enhances critical blood flow in the body (oxygenation and lymph drainage)  

HealthLight® – InfraRed (IR) Therapy: Infrared therapy is an FDA cleared treatment that has been shown to decrease pain, inflammation, speed healing and more.  By directing specific frequencies of infrared and near infrared light to the body this painless treatment can accelerate the healing process and increase circulation.  IR has been clinically shown to help with Carpal Tunnel, Peripheral Neuropathy, RSDS, Fibromyalgia and other painful conditions

 Cold Laser therapy:  We use cold laser in our office which helps improve blood flow and oxygenation and decreases inflammation to help tissues heal.

 Non-Surgical Spinal Decompression:  NSSD creates a negative disc pressure and helps to remove pressure off of the nerve.  It also provides a slow stretch of the muscles which fires up the spinal cord to increase firing of brain. 

 We may also use spinal and extremity adjustments, auditory, visual, olfactory, heat, TENS, auricular therapy and caloric stimulation to increase firing of brain.

 Once we have run the necessary tests to determine your specific condition, we can successfully treat you via proper neurological and all natural nutritional protocols.

Click here to view the embedded video.

Dear Thyroid Sufferer,

 My name is Dr. Thad Diehl, D.C.  I have been in private practice in State College, PA since 2004 and recently opened an office in Clearfield.  In our office, we focus on chronic hard to treat conditions and adress them through specific neuro-metabolic protocols.  Our unique approach has allowed us to support people with a wide variety of health concerns, including thyroid problems.  We have studied and successfully utilize protocols developed by renowned thyroid expert Datis Kharrazian, DHSc, DC, MS, MNeuroSci (www.thyroidbook.com).

Some 20 million Americans are affected by thyroid disorders…..that’s 1 in 13 people!  And more than half of those people are unaware they have a thyroid problem because it frequently goes undiagnosed…until it gets severe.

A Happy Patient Speaks

According to the National Women’s Health Information Center, 1 in 8 women will experience a thyroid disorder during their lifetime.  The reason why this fact may surprise you is because you’ve probably never heard it explained to you…that’s because most doctors are only vaguely familiar with thyroid disorders.

 Are you tired of running from doctor to doctor only to play “Russian Roulette” with different medications?  “Here try this drug, that didn’t work?  Try this one!”

 Are you tired of taking drugs that don’t fix the problem? 

 Do you continue to struggle with chronic thyroid symptoms day in and day out?  Here is a list of symptoms….

 Symptoms of Hypothyroidism

#1: Fatigue, tired, or sluggish?

#2: Cold feet and/or hands?

#3: Do you require excessive amounts of sleep to function?

#4: Do you gain weight easily?

#5: Do you have difficult or infrequent bowel movements?

#6: Are you depressed?  Do you suffer from depression?

#7: Lack of motivation?

#8: Do you suffer from morning headaches that wear off as the day progresses?

#9: Do you suffer from thinning hair or excessive hair falling out?

#10: Do you suffer from dryness of the skin and/or scalp?

#11: Do you suffer from mental sluggishness?

 Symptoms of Hyperthyroidism

 #1: Do you suffer from heart palpitations?

#2: Do you suffer from inward trembling?

#3: Do you have an increased pulse even at rest?

#4: Are you nervous and emotional?

#5: Do you suffer from insomnia?

#6: Do you suffer from night sweats?

#7: Do you have difficulty gaining weight?

 Hashimoto’s Thyroiditis is an autoimmune disorder in which the patient’s immune system attacks the thyroid.  Patient’s that suffer from Hashimoto’s  experience some or all of the above symptoms.

 Let’s talk about the thyroid gland a bit….. 

 The thyroid “runs” our metabolism—it is the “gas pedal” of the body.

 Thyroid hormones have direct effects on most organs, including the heart which beats faster and harder under the influence of increased thyroid hormones (this is why heart problems can often accompany chronic thyroid problems in women, and perhaps why heart problems are more common in women under the age of 50).

           T3 is the more biologically active hormone (it’s more important for cellular function), and in fact most of T4 (80%) is converted to T3 in the body’s peripheral tissues.  So T4 is just a precursor for the more active hormone, T3.

          One of the problems in some thyroid disorders is that you may have trouble converting T4 to T3 in your tissues (have you been checked for this?).  This can create a deficiency of T3, disrupting the body’s ability to properly regulate metabolism…leading to specific symptoms.

          There are some clinicians that are treating thyroid conditions with iodine.  I do not recommend iodine in the treatment of thyroid conditions.  According to Dr. Datis Kharriazian, author of the book, Why Do I Still Have Thyroid Symptoms?, using iodine to treat thyroid conditions is akin to throwing gasoline on a fire.

 I am here to tell you that there is NEW HOPE!

 If you’re tired of dealing with this problem and you are worried about it getting worse, please call our office or click on the box to request a case review or ask for more information